By Lena H. Sun and Rob Stein
Washington Post Staff Writers
Monday, December 6, 2010; 10:27 PM
Nebraska doctor LeRoy Carhart began working Monday at a Germantown abortion clinic, prompting protests and a prayer vigil - and shifting the national battle over abortion from the Midwest to Maryland by focusing attention on a controversial procedure that stirs up strong feelings among many Americans.
One of the few doctors in the country who openly acknowledges performing abortions late in pregnancy, Carhart said last month that he chose the Washington area because Nebraska has implemented a law making it illegal to perform abortions beyond the 20th week of pregnancy. Only a handful of doctors say publicly that they perform late abortions, and Carhart has been the target of abortion protests.
About 300 protesters gathered on a grassy knoll near the entrance to the office park where the clinic is located. As wind gusts blew, organizers urged the crowd to boycott nearby businesses to put pressure on Carhart to leave Germantown Reproductive Health Services, which already performs abortions earlier in a pregnancy.
Noting the yellow police tape that had blocked off much of the privately owned office park, the Rev. Patrick Mahoney, director of the Christian Defense Coalition, said, "I'm thrilled with all this police tape. Let's say you're an orthodontist and your little sixth-grader comes with her mom and sees all this. That's exactly what we want.
"We don't want Maryland to become the late-term abortion capital of America," he said.
"We in Germantown don't have any intention of becoming the late-term abortion capital of Maryland," said Peter Sprigg, a policy analyst with the Family Research Council, who lives nearby.
Carhart did not respond to telephone calls for comment, but abortion rights activists said he was working at the clinic.
Although several businesses said they were dismayed by Carhart's presence and antiabortion groups' vows to continue regular, peaceful demonstrations, the office condominium association said there was nothing it could do to block him.
The group held its regular meeting Monday and was informed by its legal counsel that "we have no jurisdiction over that business," said William Rinehart, one of the board members. "They are in compliance with the law."
Carhart had said he chose the D.C. area based on a combination of factors, including favorable laws.
In Maryland and Virginia, abortions are not allowed beyond when the fetus becomes viable, except in situations where the woman's "life and health" are threatened. Maryland also allows exceptions for fetal abnormalities. In both states, the doctor performing the abortion makes those determinations. In Virginia, a second doctor must approve the procedure. The District has the fewest restrictions, with no specific rules governing late-term abortions.
More than 88 percent of the 1.2 million abortions performed each year in the United States are done in the first trimester of pregnancy, and most doctors will not perform them beyond 22 or 24 weeks because of moral qualms, social stigma, legal concerns, inadequate training or lack of experience. Barely 1 percent of procedures - perhaps about 15,000 each year - are done after 21 weeks. At 37 weeks, a baby is generally considered full-term.
But exactly how many are done late in a pregnancy, precisely when in a pregnancy they are performed, by whom and under what circumstances is unclear. The government does not collect detailed data, and doctors who perform them publish little information.
Although doctors and hospitals around the country perform abortions later in pregnancies, many refer patients to doctors that specialize in the procedures when the cases are complicated.
What makes Carhart unusual is that he is one of only a relatively few who specializes in the procedure, publicly acknowledges that he does them, and advertises. As a result, doctors from around the world refer patients to him, and women desperate for the procedure seek him out.
Carhart had worked with another doctor, George Tiller, who publicly acknowledged performing the procedure at Tiller's Kansas clinic. Tiller was fatally shot by an antiabortion demonstrator in 2009 while attending church in Wichita. Carhart had hoped to continue providing the procedures at Tiller's clinic but decided to look for locations elsewhere after Tiller's family decided not to reopen that facility.
Abortion opponents condemn the procedures regardless of the circumstances. Abortion rights activists argue that late-term abortions are performed only when absolutely necessary - often when devastating abnormalities in the fetus or life-threatening problems in the woman are discovered.
Misgivings about some late-term abortions, even among those who consider themselves generally in favor of legal abortion, is probably due to several factors, including concerns that the developing fetus looks more like a fully developed child, experts said. Research showing that some fetuses appear able to discriminate between their mother's voice and other voices or possibly feel pain, for example, could play a role.
"The main reason why people have more trouble with the morality of late-term abortion is that the fetus is increasingly more developed and becomes closer and closer to a newborn baby. As it gets closer to that, it's going to be troubling to more people," said Josephine Johnston, a research scholar at the Hastings Center, a bioethics think tank in Garrison, N.Y.
In interviews, Carhart has described the situations in which he performs the procedures, citing the example of a fetus that was discovered to have no brain just weeks before delivery was expected. In other cases, the procedure will be done if the woman develops a life-threatening condition related to the pregnancy or needs to terminate to undergo cancer treatment. But Carhart has said he will also do the procedure in other circumstances, such as when a woman suffers serious emotional problems.
"There was a woman who tried to commit suicide three times. She was pregnant because she had been raped. She said every time she felt the baby move, it was the rape all over again. She could not live with that," Carhart said in a 2009 interview with The Washington Post.
One rally speaker said she had a late abortion at Tiller's clinic and has regretted it.
"My baby was in perfect condition," Kelly Stauffer said, her voice breaking. "It wasn't because I was raped. It was because I was 14 years old."
Many in the crowd came from Covenant Life Church in Gaithersburg, including about a dozen students from the church-affiliated school. Several others said they took time off from work, including John Paran, 51, who owns a carpet cleaning business in Germantown, and his wife Merilee, 47, a real estate agent.
The church doesn't typically get involved in political issues, Paran said, but "we feel this is more of a moral issue."
Staff researcher Lucy Shackelford contributed to this report.